My doctor says hormone blood tests are p

Now I'll write the family-facing answer and a printable one-pager.

Bring three things to Saturday's appointment and buy nothing new tonight: a two-week symptom log, the saliva panel report you already paid for, and every medicine box in the house.

Your doctor is largely right — with two important qualifications.

Official NHS laboratory guidance (Gloucestershire Hospitals NHS Foundation Trust, checked 24 Oct 2026) puts it plainly: "LH and FSH are NOT routinely recommended for diagnosing menopause. The diagnosis in women over 45 years of age with typical menopause symptoms is clinical. Further investigation is only warranted if there are any atypical symptoms." The same page adds: "FSH is of no value in women taking combined oestrogen and progestogen contraception or high dose progestogen."

So the honest version of "pointless" is:

• Right for the common case. Over 45, with typical symptoms and a changing period pattern, the diagnosis is made from your symptoms and your cycle history — not from a number on a lab sheet. A blood test does not add much to that.
• Not pointless in every case. If you are under 45, if your symptoms are not typical, or if something else — thyroid, anaemia — could be behind what you are feeling, then blood tests do real work, and the doctor picks which one.
• Your saliva panels are not a test that can settle it. Saliva hormone testing does not appear in the NHS menopause pages or in the NHS lab guidance as part of how menopause is diagnosed, so it cannot confirm or rule out perimenopause either way. Bring the report, let the doctor say whether it adds anything, and stop paying for more kits.
• One number worth knowing about you: if you are still on HRT containing oestrogen, a hormone level may not read the way it would without it. That is a question to put to the doctor, not something to test at home.

One blood test that may actually matter for you. You take a thyroid tablet every morning. Under- and over-active thyroid can look a lot like what people describe in perimenopause — tiredness, weight gain, brain fog, feeling hot or cold, a racing heart. A thyroid control check is a targeted test with a decision attached, not a random panel. So the sharper version of your question is not "are hormone tests pointless?" but "which tests would change my decision for me?"

Three questions to say on Saturday (screenshot this):

1. "I've tracked my cycles and symptoms for two weeks — can I see the pattern with you?"
2. "Which blood tests would actually change your decision for me — my thyroid control, anaemia if my bleeding is heavier, and is a hormone level useful at my age and given that I'm on HRT?"
3. "What should I do in the meantime that isn't a medicine, and what should make me call you before Saturday?"

1. What you already tried vs. the better next step

2. Constraints and the avoid list

• Do not buy another hormone or saliva test kit before the appointment.
• Do not start, stop, change, double or re-time HRT, your morning thyroid tablet, your blood-pressure tablet or any supplement on your own — including "just to test how I feel". That decision is the doctor's or the pharmacist's.
• Do not add calcium, vitamin D, iron, herbal or "menopause" powders without asking first; NHS advice is to talk to a doctor before herbal supplements or complementary medicines, and to ask about timing so they do not collide with your morning thyroid tablet.
• Do not use a home blood-pressure reading to add or skip a tablet.
• Do not use a relative's hormones or anything bought online.
• HRT is not contraception — if pregnancy is still possible, ask the doctor about that on Saturday, and keep using whatever contraception you were told to use.
• Do not decide anything on the saliva numbers yourself.

3. Decision tree (screenshot this)

```
Any of these? bleeding soaking a pad every hour for hours · faint/pale/sweaty
with bleeding · pain or pressure in the chest, or pain spreading
to arm/jaw/back · trouble breathing · one calf painful, swollen
or hot · face drooping, one-sided weakness, slurred speech
· sudden worst-ever headache · thoughts of harming yourself
→ YES: call your local emergency number now, or go to the emergency
department. Do not wait for Saturday.

Bleeding heavier than your usual pattern · bleeding after 12 months with no
period · bleeding or spotting on HRT that has not settled · a new breast lump
· headache building over hours or blurred vision · a racing heart that will
not settle · low mood or anxiety clearly worse than usual · any chance of
pregnancy with bleeding or pain
→ YES: call the clinic today. Do not wait for Saturday.

None of the above
→ Tonight: log, bag, three questions, cooler bedroom, hot meal, handover.
Saturday: the appointment, with the bag in your hand.
```

4. Red flags — when to stop doing it yourself

Call your local emergency number now, or go to the emergency department:

• bleeding that soaks a pad every hour for more than a couple of hours, or you feel faint, pale or sweaty with it
• pain or pressure in the chest, or pain spreading to your arm, jaw or back
• trouble breathing, or one leg/calf that is painful, swollen or hot
• one side of the face drooping, one-sided weakness or numbness, slurred speech, or confusion
• a sudden worst-ever headache
• thoughts of harming yourself — call, and stay with someone

Call the clinic the same day, without waiting for Saturday:

• bleeding heavier than your usual pattern; any bleeding once you have had no period for 12 months; on HRT, bleeding or spotting that has not settled
• a new breast lump, or a change in one breast
• a headache that builds over hours, blurred vision, or a fast or irregular heartbeat that will not settle
• low mood or anxiety clearly worse than usual, or thoughts of harming yourself
• any chance of pregnancy together with bleeding or pain

5. Tonight, 25 minutes or less (five blocks of five)

1. 5 min — log. One row for today: hot flushes (none/few/many), night sweats, sleep (good/broken), mood, bleeding (expected? heavy?), brain fog, and the day of your cycle. Fill the last two weeks as far as your notes go; gaps are fine, dates matter more than completeness.
2. 5 min — bag by the door. Every medicine box: HRT if you are still on it, the morning thyroid tablet, the blood-pressure tablet, any antibiotic, every supplement and powder. Plus the saliva panel report, your last blood-pressure reading, any recent blood results, and the questions above.
3. 5 min — phone. Type the three questions so you can read them out instead of remembering them.
4. 5 min — the room. Bedroom cool, water by the bed, one basket of light clothes, a hot meal, and fewer caffeinated or very hot drinks in the evening (NHS lists these among the common flush triggers).
5. 5 min — the handover. Say out loud who covers the school run and the elder tonight, and that no tablet changes before Saturday.

6. Caregiver scripts (screenshot this)

To whoever covers the school run and the elder tonight:
"Nothing about your tablets changes before Saturday — we're only getting the list ready. Cooler bedroom, water by the bed, and I'll take the school run."

To the doctor:
"I've tracked my cycles and symptoms for two weeks, and I've brought the hormone panel I paid for. Can you tell me what it does and doesn't add? And which blood tests would change your decision for me — my thyroid control, anaemia, and is a hormone level useful given my age and that I'm on HRT?"

To the doctor, second question:
"What should I do in the meantime that isn't a medicine, and what should make me call you before Saturday?"

To the pharmacist:
"I take a thyroid tablet in the morning, a blood-pressure tablet, and HRT, and I'm thinking about calcium and vitamin D. Does the timing matter, and can you check my supplements for anything I'd be doubling?"

To a relative or elder:
"The decision is hers and her doctor's. Our job this week is the school run and Saturday's list. Bleeding that soaks through, pain in the chest, trouble breathing, one-sided weakness, or a sudden worst headache means call, not wait."

7. What "success" looks like in 24 hours

Not a cure — symptoms may well still be there tomorrow. Success tonight is readiness, not relief:

• today's log row filled in (5 minutes)
• one bag by the door with every box and every result
• three questions written in your phone and read once out loud
• a cool bedroom, water by the bed, one hot meal eaten
• the handover said out loud to someone
• zero new test kits bought, and zero medicines started, stopped or re-timed

If those six are done, Saturday is a good appointment instead of a wasted one.

This is not a diagnosis and it does not replace your doctor. It is preparation for a conversation you are going to have anyway. The guidance quoted here is UK NHS public information, checked on 24 October 2026; your own clinic's local advice and your own prescriber's plan come first.

I've also put a printable one-page version — the log table, the three questions, the red flags and tonight's 25-minute plan — in your inbox: perimenopause-visit-sheet-2026-10-24-9be7ade3.pdf

Source: nhs-conditions https://www.nhs.uk/conditions/menopause-and-perimenopause/symptoms/
Source: nhs-conditions https://www.nhs.uk/conditions/menopause-and-perimenopause/things-you-can-do/
Source: nhs-conditions:nhs-trust-lh-fsh https://www.gloshospitals.nhs.uk/our-services/services-we-offer/pathology/tests-and-investigations/lh-and-fsh-gonadotrophins/
Source: merck-pro https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/thyroid-disorders/hypothyroidism